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Routes of administration | Oral |
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Elimination half-life | ~4.5 hours |
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Formula | C24H27FN2O |
Molar mass | 378.491 g·mol−1 |
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Cebranopadol (developmental code GRT-6005) is an opioid analgesic of the benzenoid class which is currently under development internationally by Grünenthal, a German pharmaceutical company, and its partner Depomed, a pharmaceutical company in the United States, for the treatment of a variety of different acute and chronic pain states.[1][2][3] As of November 2014, it is in phase III clinical trials.
Cebranopadol is unique in its mechanism of action as an opioid, binding to and activating all four of the opioid receptors; it acts as a full agonist of the μ-opioid receptor (Ki = 0.7 nM; EC50 = 1.2 nM; IA = 104%), and δ-opioid receptor (Ki = 18 nM; EC50 = 110 nM; IA = 105%), and as a partial agonist of the nociceptin receptor (Ki = 0.9 nM; EC50 = 13.0 nM; IA = 89%) and κ-opioid receptor (Ki = 2.6 nM; EC50 = 17 nM; IA = 67%).[1] The EC50 values of 0.5–5.6 μg/kg when introduced intravenously and 25.1 μg/kg after oral administration.[4]
Cebranopadol shows highly potent and effective antinociceptive and antihypertensive effects in a variety of different animal models of pain.[1] Notably, it has also been found to be more potent in models of chronic neuropathic pain than acute nociceptive pain compared to selective μ-opioid receptor agonists.[1] Relative to morphine, tolerance to the analgesic effects of cebranopadol has been found to be delayed (26 days versus 11 days for complete tolerance).[1] In addition, unlike morphine, cebranopadol has not been found to affect motor coordination or reduce respiration in animals at doses in or over the dosage range for analgesia.[1] As such, it may have improved and prolonged efficacy and greater tolerability in comparison to currently available opioid analgesics.[1]
As an agonist of the κ-opioid receptor, cebranopadol may have the capacity to produce psychotomimetic effects, dysphoria, and other adverse reactions at sufficiently high doses, a property which could potentially limit its practical clinical dosage range, but would likely reduce the occurrence of patients taking more than their prescribed dose.[5]